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Indigestion

Indigestion (dyspepsia) affects around four in every 10 people in the UK every year. It's a term that refers to several symptoms, including pain or discomfort in your upper abdomen (tummy). You’re most likely to notice the symptoms after you’ve eaten, but you can get them at any time. You may get indigestion every day or once in a while.

Most people with indigestion don’t see their GP if their symptoms are mild. You may be able to manage your indigestion yourself by taking over-the-counter medicines from a pharmacy. But if your symptoms are severe, come on after you exercise, or are worse or different to your usual indigestion, contact your GP.

Indigestion can sometimes be a symptom of a more serious condition. See your GP if you:

are losing weight but don’t know why

have persistent symptoms of indigestion for the first time and you’re 55 or older

are finding it difficult to swallow

are vomiting regularly

notice blood in your vomit or faeces

have black, tar-like stools or what looks like coffee grounds in your vomit

have had your symptoms for more than a few weeks

Occasionally a heart attack can cause indigestion-like symptoms. Call for emergency help if you have the following symptoms alongside indigestion:

Your GP will ask about your symptoms and what makes them better or worse (such as alcohol, exercise or certain foods). They’ll also examine you and ask you about your medical history.

Your GP may recommend further tests.

Breath tests, blood tests or faecal (stool) tests. These will check you’re not losing blood, which can lead to anaemia. They can also check for Helicobacter pylori (H. pylori), which is a bacterial infection.

An upper gastrointestinal endoscopy (gastroscopy). This looks inside your oesophagus (the pipe that links your throat to your stomach), stomach and the first part of your small bowel (duodenum). During a gastroscopy, your doctor may take a biopsy (a small sample of tissue). This will be sent to a laboratory for testing.

A barium meal X-ray. If you have a barium meal, you’ll be asked to drink fluid containing barium (a substance that shows up on X-rays). X-ray images will show the inside of your stomach and small bowel more clearly.

If you have indigestion, there are a few things you can do to reduce your symptoms.

Lose weight if you’re overweight.

Cut down on foods or drinks that you think may trigger your symptoms. It may help to keep a food diary to track what you eat and when your symptoms flare up and down. Common triggers include chocolate, coffee and fatty foods.

Stop smoking or smoke less.

Drink less alcohol

Sleep in a more upright position by raising the head of your bed with blocks of wood or bricks

Medicines

Over-the-counter medicines

You can buy several indigestion medicines from your pharmacist without a prescription. Always read the patient information leaflet that comes with your medicine and ask your pharmacist for advice if you’re unsure about anything.

You can take antacids for occasional symptoms. These relieve indigestion by neutralising acid in your stomach. Antacids usually contain magnesium or aluminium. You can take antacids when your symptoms occur or if you’re expecting them to flare up (such as before you go to bed). Liquid products tend to work better than tablets.

Some indigestion medicines contain antacids with alginates or simeticone. Alginates form a raft over your stomach contents and may help if acid rises from your stomach into your oesophagus, causing heartburn. Simeticone is an antifoaming agent, which breaks down bubbles of gas in your digestive system to relieve wind and bloating.

If antacids don’t work, or you need to take them regularly to relieve your symptoms, your pharmacist may recommend some other medicines. Proton pump inhibitors, such as omeprazole, work by stopping your stomach producing acid. You can take an over-the-counter proton pump inhibitor for up to four weeks.

If you can’t take a proton pump inhibitor, you may be able to try H2 receptor-antagonists (H2RAs), such as cimetidine and ranitidine instead. These also work by reducing how much stomach acid you produce.

Prescription-only medicines

If a Helicobacter Pylori (H. pylori) infection is causing your indigestion (see our causes section below), your GP may recommend a combination of antibiotics to kill off the bacterial infection and medicines such as proton pump inhibitors to reduce the amount of acid your stomach produces.

If a proton pump inhibitor controls your symptoms well, your GP, after assessing your condition, may prescribe one that you can take for a longer period of time. They’ll usually suggest you take a lower dose once your symptoms are under control. If you can’t take a proton pump inhibitor, you may be prescribed an H2 receptor-antagonist instead. Ask your GP or pharmacist for more information.

Always ask your GP or pharmacist for advice and read the patient information leaflet that comes with your medicine.

An overview of your health

Find out how a Bupa health assessment can help you understand your health, identify future health risks, and offer practical advice for a healthier you.

Your GP may not find a specific cause for your indigestion. But certain things may trigger off your symptoms, such as:

being overweight

drinking too much alcohol

eating certain foods, such as fatty foods

smoking

stress and anxiety

medicines, such as aspirin and non-steroidal anti-inflammatory medicines (NSAIDs)

Underlying health conditions

Indigestion can be caused by a number of health conditions.

You may have a peptic ulcer, which is a break in the lining of your stomach or small bowel. You can get a peptic ulcer if stomach acid, which helps digest your food, damages your stomach lining. A peptic ulcer can also be caused by Helicobacter pylori (H. pylori) bacteria that sometimes live in your stomach. The bacteria can damage your stomach lining by increasing the amount of acid produced in your stomach.

Your indigestion may be caused by a condition called gastro-oesophageal reflux disease (GORD). This is when acid leaks out of your stomach and into your oesophagus. See our FAQ on GORD for more information.

Sometimes indigestion-like symptoms aren’t related to your digestive system. They may be caused by something else, such as a heart attack.

Pregnancy

You may get indigestion during pregnancy due to changing hormone levels and the increased pressure in your abdomen (tummy). The symptoms can start at any stage of your pregnancy. See our FAQ on Pregnancy for more information.

Wind and bloating are very common. Changing things like your diet, and certain lifestyle factors can help to reduce your symptoms.

More information

You usually pass wind out through your rectum (flatulence) or your mouth (belching or burping) several times a day. You don’t notice this happening as it’s in tiny amounts each time. But when gas doesn’t pass out of your body easily, or there’s too much gas, this can cause bloating and discomfort.

Swallowing too much air is a common cause of belching or burping. To prevent this you should avoid:

eating or drinking too quickly

chew gum

drinking fizzy drinks

smoking

You produce gas in your bowel when the food you’ve eaten is broken down to be absorbed. Certain foods such as pulses, bran and fruit, can increase the amount of gas you produce, so try to limit these. Regular exercise may also help to reduce your symptoms.

If your symptoms don’t get better after you make changes to your diet, or they get worse, speak to your GP. Most people with wind and bloating don’t have an underlying health problem. But flatulence can sometimes be caused by a condition such as constipation, irritable bowel syndrome or lactose intolerance.

If you’re lactose intolerant, your stomach and small bowel can’t break down a sugar called lactose, which is found in milk and other dairy products. Instead, the lactose is broken down in your large bowel, which produces large amounts of gas. Your GP may advise having a diary-free diet for a while, to see if this is the cause of your symptoms. If you have lactose intolerance, your GP may recommend eating and drinking less milk and other dairy products.

If you have GORD, your stomach acid rises into your oesophagus. You may have an acidic taste in your mouth or burning sensation in your upper chest (heartburn). Taking medicines or changing your lifestyle may help your symptoms.

More information

If you have GORD, it’s likely that the valve between your oesophagus and stomach doesn’t work properly. Your oesophagus is the pipe that leads from your throat to your stomach.

Usually the valve relaxes (opens) when you swallow food and then closes again. But if you have GORD, your valve may be weak or it may relax too often. This means some of your stomach contents can come back up into your oesophagus (called reflux).

You can buy several medicines over the counter from your pharmacist to help relieve your symptoms. These include antacids, which neutralise your stomach acid. Some medicines also contain an alginate, which forms a barrier over your stomach contents to prevent reflux. Always read the patient information leaflet that comes with your medicine. If you have any questions, ask your pharmacist for advice.

Some foods, such as coffee, chocolate or fatty foods, may make your symptoms worse. Keep a diary of what you eat and when you get heartburn – this will help to identify if a particular food is triggering your symptoms. It may also help if you drink less alcohol, stop smoking and lose any excess weight. Try eating smaller meals and having your evening meal three hours before you go to bed too.

You’re most likely to experience indigestion in pregnancy because of rising hormonal levels. It may also be because your growing baby in your uterus (womb) presses against your stomach.

More information

Between four and eight in every 10 women in the UK are thought to get indigestion at some point during their pregnancy. This is usually caused by gastro-oesophageal reflux disease (GORD). Rising levels of progesterone and oestrogen hormones make the valve between your oesophagus and stomach more relaxed. This means some of your stomach contents can come back up into your oesophagus (called reflux).

You may have pain or discomfort in your upper tummy or chest, with belching, nausea and a burning feeling (heartburn). Your symptoms may start at any time during your pregnancy, but these should disappear again once your baby is born. You’re more likely to get indigestion if you had it before you were pregnant or during a previous pregnancy.

If you develop indigestion during pregnancy, contact your midwife. They may recommend you try antacids and alginates, as you can take these safely during pregnancy.

We’d love to know what you think about what you’ve just been reading and looking at – we’ll use it to improve our information. If you’d like to give us some feedback, our short form below will take just a few minutes to complete. And if there's a question you want to ask that hasn't been answered here, please submit it to us. Although we can't respond to specific questions directly, we’ll aim to include the answer to it when we next review this topic.

Peer reviewed by Dr Adrian Raby, General Practitioner and Clinical Lecturer, June 2016

Next review due June 2019

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